“Numerous studies have shown that high uric acid levels are associated with metabolic syndrome and NAFLD, but to date, to the best of our knowledge, no studies have tested the independence of associations among uric acid concentrations, fructose consumption, and NASH confirmed by biopsy.

The study involved 271 Italian obese children of which 155 were boys and all had a mean age of 12.5 years with NAFLD who underwent liver biopsy.

They filled out a questionnaire listing what they ate and drank, when and how often.

Their main source of fructose was fizzy and soft drinks with nine in ten drinking one or more times a week.

Almost all - 95 per cent - regularly consumed morning and afternoon snacks consisting of crackers, pizza and salty food, biscuits, yogurt, or other snacks.

Of the participants 37.6 per cent had NASH and 47 per cent with NASH had high uric acid compared with 29.7 per cent of patients who did not have NASH.

Fructose consumption was independently associated with high uric acid, which occurred more frequently in patients with NASH than in not-NASH patients.

Dr. Nobili concluded: “In this study, we show for the first time that uric acid concentrations and dietary fructose consumption are independently and positively associated with NASH.

“The development of NASH may markedly affect life expectancy and quality of life in affected individuals and therefore it is crucial to understand the risk factors for NASH in children and adolescents in order to design effective interventions which can be used safely to treat this young group of patients.

A recent study suggested fructose is the deadliest sugar you can eat because it boost harmful cholesterol raising the risk of diabetes, heart attacks and stroke.